Journal of Current Glaucoma Practice最新文献

{"title":"Acute Attack of Glaucoma after Scleral Melting and Iris Blockage of the Surgical Ostium: A Case Report of a Complication Derived from a Mitomycin C Supplemented Trabeculectomy.","authors":"Jose A Paczka,&nbsp;Ana M Ponce-Horta,&nbsp;Andrea Tornero-Jimenez","doi":"10.5005/jp-journals-10078-1373","DOIUrl":"10.5005/jp-journals-10078-1373","url":null,"abstract":"<p><strong>Aim: </strong>To describe a case of an acute attack of glaucoma due to scleral melting in the area where a trabeculectomy was previously done. This condition resulted from the blockage of the surgical opening due to an iris prolapse in an eye that was previously supplemented with mitomycin C (MMC) during a filtering surgery and bleb needling revision.</p><p><strong>Case description: </strong>A 74-year-old Mexican female with a prior glaucoma diagnosis who assisted to an appointment presenting an acute ocular hypertensive crisis after several months of adequately controlled intraocular pressure (IOP). Ocular hypertension had been regulated after undergoing a trabeculectomy and bleb needling revision; both supplemented with MMC. The severe IOP increase occurred due to uveal tissue blockage in the filtering site, related to melting of the sclera in the same area. The patient was successfully treated through the use of a scleral patch graft and the implantation of an Ahmed valve.</p><p><strong>Conclusion: </strong>An acute attack of glaucoma associated with scleromalacia after trabeculectomy and needling has not been previously reported and is currently attributed to MMC supplementation. Nevertheless, the use of a scleral patch graft and further glaucoma surgery seems to be an efficient way to treat this condition.</p><p><strong>Clinical significance: </strong>Even though this complication was appropriately managed with this patient, we want to prevent further cases like this through the judicious and careful use of MMC.</p><p><strong>How to cite this article: </strong>Paczka JA, Ponce-Horta AM, Tornero-Jimenez A. Acute Attack of Glaucoma after Scleral Melting and Iris Blockage of the Surgical Ostium: A Case Report of a Complication derived from a Mitomycin C Supplemented Trabeculectomy. J Curr Glaucoma Pract 2022;16(3):199-204.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 3","pages":"199-204"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/79/jocgp-16-199.PMC9905880.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Onset Uveitis-glaucoma-hyphema Syndrome with Out-the-bag Placement of Intraocular Lens.","authors":"Benjamin Zhou,&nbsp;Vladislav P Bekerman,&nbsp;David S Chu,&nbsp;Albert S Khouri","doi":"10.5005/jp-journals-10078-1381","DOIUrl":"10.5005/jp-journals-10078-1381","url":null,"abstract":"<p><strong>Aim: </strong>To report a case of uveitis-glaucoma-hyphema (UGH) syndrome secondary to a tilted toric intraocular lens (IOL).</p><p><strong>Background: </strong>Over the past few decades, upgrades in lens design, surgical techniques, and posterior chamber IOLs have drastically decreased the incidence of UGH syndrome. We present a rare case of UGH syndrome developing 2 years after a seemingly uneventful cataract surgery and its subsequent management.</p><p><strong>Case description: </strong>A 69-year-old female presented with episodes of sudden visual disturbance in her right eye 2 years after a seemingly uneventful cataract surgery with placement of a toric IOL. Workup included ultrasound biomicroscopy (UBM), which revealed a tilted IOL and confirmed haptic-induced iris transillumination defects consistent with the diagnosis of UGH syndrome. The patient underwent surgical repositioning of the IOL, which led to the resolution of UGH.</p><p><strong>Conclusion: </strong>Uuveitis-glaucoma-hyphema developed from a tilted toric IOL inducing posterior iris chaffing. Careful examination and UBM revealed the IOL and haptic out of the bag position, which was critical in determining the underlying UGH mechanism. The surgical intervention led to the resolution of UGH syndrome.</p><p><strong>Clinical significance: </strong>In patients with a history of uneventful cataract surgery who develop UGH-like symptoms, continued examination of implant orientation and haptic position is critical in preventing the need for future procedures.</p><p><strong>How to cite this article: </strong>Zhou B, Bekerman VP, Chu DS, <i>et al.</i> Late Onset Uveitis-glaucoma-hyphema Syndrome with Out-the-bag Placement of Intraocular Lens. J Curr Glaucoma Pract 2022;16(3):205-207.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 3","pages":"205-207"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/f0/jocgp-16-205.PMC9905877.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Niacinamide and Neuroprotection: The Glaucoma Holy Grail.","authors":"Shibal Bhartiya","doi":"10.5005/jp-journals-10078-1390","DOIUrl":"10.5005/jp-journals-10078-1390","url":null,"abstract":"<p><p><b>How to cite this article:</b> Bhartiya S. Niacinamide and Neuroprotection: The Glaucoma Holy Grail. J Curr Glaucoma Pract 2022;16(3):141-143.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 3","pages":"141-143"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/10/jocgp-16-141.PMC9905873.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10738795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medium-term Outcomes of Micropulse Transscleral Cyclophotocoagulation in Refractory Glaucoma.","authors":"Inigo Tejada Valle,&nbsp;Sara Pose Bazarra,&nbsp;Miguel Ferreira Taboas,&nbsp;Sara Rubio Cid,&nbsp;Maria Dolores Alvarez Diaz","doi":"10.5005/jp-journals-10078-1370","DOIUrl":"https://doi.org/10.5005/jp-journals-10078-1370","url":null,"abstract":"<p><strong>Aim: </strong>To describe our first experience with the efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) procedure in the treatment of different glaucoma subtypes refractory to topical medication using a standard protocol.</p><p><strong>Materials and methods: </strong>Retrospective, interventional study in a series of 35 eyes of 34 patients with refractory glaucoma who underwent MP-TSCPC. Treatment success was defined as an intraocular pressure (IOP) reduction of at least 20% compared to baseline with or without IOP-lowering medication or eventual retreatment.</p><p><strong>Results: </strong>Mean age was 78.0 years. The glaucoma subtypes included pseudoexfoliative (PSXG) (16), neovascular (NVG) (9), primary open-angle (POAG) (7), congenital (1), aphakic (1), and secondary glaucoma (1). The mean preoperative IOP was 31.8 ± 10.5 mm Hg and at month 12 was 21.9 ± 10.6 mm Hg (<i>p</i> < 0.05). The average baseline number of glaucoma medications pretreatment was 3.0 ± 1.0 and at month 12 was 2.3 ± 1.2 (<i>p</i> = 0.114). At month 12, success was achieved in 15 eyes (42.9%) with an IOP-lowering effect of 31.1%. PSXG was correlated with IOP reduction (<i>p</i> = 0.037) and had a higher likelihood of success (<i>p</i> = 0.031). As complications, there was one case of prolonged hypotony and another case of developed postoperative neurotrophic keratopathy.</p><p><strong>Conclusion: </strong>Using our standardized protocol, MP-TSCPC seems a safe and relatively effective treatment in the medium-term for refractory glaucoma, achieving good results in PSXG.</p><p><strong>Clinical significance: </strong>There are few studies published about MP-TSCPC. The results of our study contribute to expanding on the short evidence reported at present, emphasizing our considerable percentage of PSGX.</p><p><strong>How to cite this article: </strong>Valle IT, Bazarra SP, Taboas MF, <i>et al.</i> Medium-term Outcomes of Micropulse Transscleral Cyclophotocoagulation in Refractory Glaucoma. J Curr Glaucoma Pract 2022;16(2):91-95.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 2","pages":"91-95"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/72/jocgp-16-91.PMC9452714.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40373765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glaucoma Screening: Is AI the Answer?","authors":"Shibal Bhartiya","doi":"10.5005/jp-journals-10078-1380","DOIUrl":"https://doi.org/10.5005/jp-journals-10078-1380","url":null,"abstract":"<p><p><b>How to cite this article:</b> Bhartiya S. Glaucoma Screening: Is AI the Answer? J Curr Glaucoma Pract 2022;16(2):71-73.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 2","pages":"71-73"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/03/jocgp-16-71.PMC9452706.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of iStent Inject Implantation in Manual and Femtosecond Laser-assisted Cataract Surgery before Lens Extraction.","authors":"David Kevin Manning,&nbsp;Ali Haider,&nbsp;Colin Clement,&nbsp;Deepa Viswanathan","doi":"10.5005/jp-journals-10078-1374","DOIUrl":"https://doi.org/10.5005/jp-journals-10078-1374","url":null,"abstract":"<p><strong>Aim: </strong>To describe the efficacy and safety of iStent implantation prior to phacoemulsification in manual as well as femtosecond laser-assisted cataract surgery (FLACS), and highlight this approach as a reasonable, if not necessary, step to advance one's ability and confidence in the use of microinvasive glaucoma surgery (MIGS) technology in phakic patients.</p><p><strong>Methods: </strong>A retrospective consecutive case series of patients with open angle glaucoma or ocular hypertension who underwent iStent inject implantation followed by cataract surgery (manual or FLACS). All cases underwent postoperative video review and were assessed and classified for intraoperative lens injury and hyphaema. Postoperative data included intraocular pressure (IOP), medication usage and adverse events.</p><p><strong>Results: </strong>Sixty-three eyes (<i>n</i> = 40 manual, <i>n</i> = 23 FLACS) were analyzed. Preoperatively, the mean IOP was 19.2 ± 4.9 mm Hg on 1.4 ± 0.96 mean medications, with 100% of eyes treated with medication. Intraoperatively, no lens injury was identified, and no significant hyphaema that impeded surgery occurred. At 6 months postoperative, mean IOP was 14.2 ± 1.8 mm Hg (38% reduction: <i>p</i> < 0.001), and >90% of eyes had IOP ≤ 16 mm Hg. The mean number of medications reduced to 0.11 ± 0.3 (92% reduction: <i>p</i> < 0.001), with 89% of eyes medication free. Safety was excellent for both manual and FLACS, with two iStents implanted in all eyes, and no cases of significant hyphaema or lens injury.</p><p><strong>Conclusion: </strong>Early implantation is safe, maximizes corneal clarity and angle visualization, avoids the risk of non-implantation due to surgical complications, and has a high success rate in both manual cataract surgery and the setting of FLACS.</p><p><strong>Clinical significance: </strong>The conventional recommended approach of iStent implantation following cataract extraction has been adopted by many, however, with the advent of stand-alone procedures and concern about potential lens injury, there is an opportunity to gain experience with minimal risk in patients undergoing MIGS procedures combined with cataract surgery by implanting iStents at the start of the procedure. There is currently little emphasis or data published in the literature on an early approach to implantation to guide surgeons.</p><p><strong>How to cite this article: </strong>Manning DK, Haider A, Clement C, <i>et al.</i> Efficacy and Safety of iStent Inject Implantation in Manual and Femtosecond Laser-assisted Cataract Surgery before Lens Extraction. J Curr Glaucoma Pract 2022;16(2):105-110.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 2","pages":"105-110"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/81/jocgp-16-105.PMC9452712.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Selective Laser Trabeculoplasty in Primary Angle-closure Glaucoma after Peripheral Iridotomy.","authors":"Tee Wongwuticomjon,&nbsp;Sunee Chansangpetch,&nbsp;Abhibol Inobhas,&nbsp;Visanee Tantisevi","doi":"10.5005/jp-journals-10078-1377","DOIUrl":"https://doi.org/10.5005/jp-journals-10078-1377","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the efficacy of selective laser trabeculoplasty (SLT) in Southeast Asian eyes with primary open-angle glaucoma (POAG) vs primary angle-closure glaucoma after peripheral iridotomy (PACG-PI).</p><p><strong>Materials and methods: </strong>Records of glaucoma patients who underwent SLT and had a 24-month follow-up were reviewed. Pre- and post-treatment intraocular pressure (IOP), percentage of IOP reduction in POAG, and PACG-PI groups, and probability of failure were analyzed. SLT failure was defined as any eye that did not have IOP lower than 20% compared to the baseline or had an IOP higher than the baseline on two consecutive visits. Adding medication, repeating SLT, or surgical intervention to control IOP was also considered a failure.</p><p><strong>Results: </strong>Sixty-three POAG and 12 PACG-PI eyes were eligible. The mean (standard deviation [SD]) age was 62.9 (10.2) years in POAG and 60.3 (6.2) years in PACG-PI. Mean (SD) prelaser IOP in POAG was 19.0 (4.4) mm Hg and 20.7 (4.7) mm Hg in PACG-PI. At 24 months post-SLT, mean (SD) IOP was 14.1 (4.7) mm Hg and 13.6 (2.0) mm Hg in POAG and PACG-PI, respectively. There was no significant difference in percentage of IOP reduction (22.8 ± 23.0% for POAG and 30.7 ± 19.5% for PACG-PI, <i>p</i> = 0.96), or failure probability (<i>p</i> = 0.10) between both groups.</p><p><strong>Conclusion: </strong>The efficacy of SLT at 24 months was comparable between POAG and PACG-PI.</p><p><strong>Clinical significance: </strong>Selective laser trabeculoplasty may be an option to further lower IOP in eyes with angle closure with visible trabecular meshwork (TM) after iridotomy, especially in highly pigmented eyes of Southeast Asians.</p><p><strong>How to cite this article: </strong>Wongwuticomjon T, Chansangpetch S, Inobhas A, <i>et al.</i> Efficacy of Selective Laser Trabeculoplasty in Primary Angle-closure Glaucoma after Peripheral Iridotomy. J Curr Glaucoma Pract 2022;16(2):124-127.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 2","pages":"124-127"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/0a/jocgp-16-124.PMC9452708.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40373764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival in Patients with Neovascular Glaucoma Following Tube Shunt Implant or Cyclodestructive Procedure.","authors":"Yujia Zhou,&nbsp;Sydni Coleman,&nbsp;Jess Boysen,&nbsp;Morgan L Pansegrau,&nbsp;Martha M Wright,&nbsp;Emmett F Carpel,&nbsp;Karen R Armbrust","doi":"10.5005/jp-journals-10078-1357","DOIUrl":"https://doi.org/10.5005/jp-journals-10078-1357","url":null,"abstract":"Abstract Purpose The study purpose was to assess patient survival after tube shunt implant or cyclodestructive procedure for neovascular glaucoma and to determine whether specific preoperative factors are predictive of survival. Materials and methods A retrospective chart review was performed on patients with neovascular glaucoma who underwent tube shunt implant and/or cyclodestructive procedure between January 2002 and December 2019 at the Minneapolis Veterans Affairs Health Care System. Patient survival was compared to the age and gender-matched Minnesota population. Cox regression analyses were performed to evaluate preoperative parameters and survival. Results Tube shunt alone was implanted in 30 eyes, cyclodestruction alone was performed in nine eyes, and two eyes underwent both (n = 41 eyes, 39 patients). The postoperative 5-year survival rate was 62% in neovascular glaucoma patients compared to 80% in controls. Survival did not differ significantly based on neovascular glaucoma etiology. Preoperative best-corrected visual acuity of the neovascular glaucoma-affected eye (p = 0.05) and Charlson Comorbidity Index (p = 0.02) were associated with survival, but preoperative maximum intraocular pressure, hemoglobin A1c, and creatinine were not. The mean intraocular pressure at 6 months postprocedure was 14 mm Hg for tube shunt and 27 mm Hg for cyclodestruction (p = 0.03). Conclusion Neovascular glaucoma patients have reduced survival, but the majority survived at least 5-year postprocedure. Ophthalmologists should consider patient survival and factors predictive of survival when planning procedures for neovascular glaucoma. Clinical significance Our findings provide an updated perspective on survival in the setting of neovascular glaucoma and can help ophthalmologists provide patient-centered and holistic care. How to cite this article Zhou Y, Coleman S, Boysen J, et al. Survival in Patients with Neovascular Glaucoma Following Tube Shunt Implant or Cyclodestructive Procedure. J Curr Glaucoma Pract 2022;16(2):74-78.","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 2","pages":"74-78"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3d/f1/jocgp-16-74.PMC9452707.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the Ideal Treatment Protocol and Success Predictors for Double-session Micropulse Transscleral Laser for Glaucoma Management.","authors":"Leopoldo Magacho,&nbsp;Francisco E Lima,&nbsp;Marcos P Ávila","doi":"10.5005/jp-journals-10078-1375","DOIUrl":"https://doi.org/10.5005/jp-journals-10078-1375","url":null,"abstract":"<p><strong>Aim: </strong>To identify the ideal treatment protocol and success predictors for double-session micropulse transscleral (MP3) laser for glaucoma management.</p><p><strong>Materials and methods: </strong>Patients who underwent double-session MP3, with a minimum follow-up of 6 months, were retrospectively investigated. Logistic regression analysis was used to verify preoperative success predictors. The following comparisons were made: (1) Between eyes that obtained surgical success vs failure, (2) According to the time required for MP3, and (3) Considering only eyes that required retreatment.</p><p><strong>Results: </strong>A total of 191 eyes from 148 patients were included. The preoperative intraocular pressure (IOP) was significantly higher than at last follow-up visit (27.3 ± 6.9 vs 14.6 ± 6.0 mm Hg, <i>p</i> < 0.001). Success was observed in 90.5% of the eyes. On logistic regression analysis with preoperative IOP and MP3 time as independent variables, only previous IOP was identified as a statistically significant factor (<i>p</i> = 0.004), with lower IOP relating to higher success. Eyes that required lower MP3 time underwent more MP3 procedures than those with higher MP3 time (1.2 ± 0.5 vs 1.1 ± 0.3, <i>p</i> = 0.03). In the 36 eyes that underwent retreatment, preoperative IOP was higher (31.6 ± 7.4 vs 26.3 ± 6.4 mm Hg, <i>p</i> < 0.001); eyes with successful IOP treatment had a higher MP3 treatment time at the first surgery than eyes with failed IOP correction (364.1 ± 68.2 vs 330.0 ± 18.0 seconds, <i>p</i> = 0.02).</p><p><strong>Conclusion: </strong>Thus, an ideal double-session MP3 protocol should use a high laser energy at the first surgery, and a high preoperative IOP can be considered as a predictor of surgical failure.</p><p><strong>Clinical significance: </strong>This is the first study to give special attention to the double-session MP3 protocol and success predictors.</p><p><strong>How to cite this article: </strong>Magacho L, Lima FE, Ávila MP. Estimating the Ideal Treatment Protocol and Success Predictors for Double-session Micropulse Transscleral Laser for Glaucoma Management. J Curr Glaucoma Pract 2022;16(2):111-116.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 2","pages":"111-116"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/9c/jocgp-16-111.PMC9452711.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40373763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suprachoroidal Hemorrhage after XEN Gel Implant Requiring Surgical Drainage.","authors":"Kevin Wang,&nbsp;Jay C Wang,&nbsp;Soshian Sarrafpour","doi":"10.5005/jp-journals-10078-1378","DOIUrl":"https://doi.org/10.5005/jp-journals-10078-1378","url":null,"abstract":"<p><strong>Aim: </strong>To describe a case of a patient on anticoagulation who underwent XEN45 (XEN) gel stent placement and subsequently developed kissing suprachoroidal hemorrhages (SCHs) requiring surgical drainage.</p><p><strong>Background: </strong>Minimally invasive glaucoma surgery (MIGS) aims to achieve effective control of intraocular pressure (IOP) while minimizing the complications associated with traditional glaucoma surgeries. Rarely, a severe complication of intraocular surgery is SCH, which can result from early postoperative hypotony. The XEN gel stent is a MIGS device that theoretically avoids the risk of hypotony due to its outflow resistance properties. However, cases of SCH associated with XEN gel stents have been reported.</p><p><strong>Case description: </strong>A monocular 86-year-old Caucasian male with glaucoma and atrial fibrillation on rivaroxaban underwent routine XEN gel stent placement with mitomycin C in his only seeing eye. On postoperative day 3, he presented with severe eye pain and worsening vision. He was found to have a SCH that gradually progressed to kissing suprachoroidals that required surgical drainage. After extensive discussion, the decision was made to hold the patient's rivaroxaban given his monocular status. The patient subsequently had a cerebral vascular accident (CVA) 1 week after drainage, but his symptoms gradually resolved after restarting anticoagulation. Two months after drainage, the patient's SCH had completely resolved, and he had recovered baseline visual acuity with excellent IOP control-off medications.</p><p><strong>Conclusion: </strong>This case highlights the importance of quick and appropriate management of complications following glaucoma surgery, as well as discussion with patients regarding risks of treatments and return precautions. It also is a reminder that although many new surgical interventions are \"minimally invasive,\" those like the XEN that are more effective at IOP control may have a similar risk profile to more traditional surgeries like trabeculectomy. As such, risk factors like anticoagulation use and older age should be considered in anticipation of surgical intervention.</p><p><strong>Clinical significance: </strong>The XEN gel stent is a new surgical option for glaucoma patients that asserts a better safety profile than traditional surgeries like trabeculectomy, but our case of kissing SCHs requiring surgical intervention following XEN placement reminds us that even minimally invasive surgeries can have devastating complications.</p><p><strong>How to cite this article: </strong>Wang K, Wang JC, Sarrafpour S. Suprachoroidal Hemorrhage after XEN Gel Implant Requiring Surgical Drainage. J Curr Glaucoma Pract 2022;16(2):132-135.</p>","PeriodicalId":15419,"journal":{"name":"Journal of Current Glaucoma Practice","volume":"16 2","pages":"132-135"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/52/fd/jocgp-16-132.PMC9452709.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40373766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}